Provider Demographics
NPI:1528033164
Name:BETHESDA RADIOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:BETHESDA RADIOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-736-1200
Mailing Address - Street 1:200 KNUTH RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4693
Mailing Address - Country:US
Mailing Address - Phone:561-736-1200
Mailing Address - Fax:561-742-1919
Practice Address - Street 1:2815 S SEACREST BLVD
Practice Address - Street 2:ATTENTION BETSY COX
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7934
Practice Address - Country:US
Practice Address - Phone:561-736-1200
Practice Address - Fax:561-742-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCA0558OtherRAILROAD MEDICARE
FL055379400Medicaid
FLCA0558Medicare PIN
FL055379400Medicaid